Stop TB Partnership Communiqué
Issue No.26
November 2002

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   Website access to information:

News from the Stop TB Partnership Secretariat (web site)

The Partnership takes this opportunity to congratulate Dr Jacob Kumaresan, our Executive Secretary, who has recently been appointed as President of the International Trachoma Initiative. He is due to assume office on 1st March 2003.

Dr Kumaresan has been working in the Stop TB department at the WHO for 10 years and was appointed as Executive Secretary in December 2000. 

Under Dr Kumaresan's leadership, the establishment of a strong Secretariat team and the Global Drug Facility have made significant advances in the combat against TB. His guidance to the Stop TB Partnership will be greatly missed.

Within the next weeks a process will be outlined for the selection and appointment of a replacement for Dr Kumaresan. We welcome your suggestions on suitable candidates for early next year.

Call for nominations for NGO positions to Global Fund Board:

For currently available NGO Positions on the Board of Directors of the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Fund), please e-mail Tanya Jewell at tanyaj@icaso.org to receive the document "Call for Nominations to The Fund Board". This document highlights key information about the application process.

Stop TB Coordinating Board Cape Town, South Africa, 28-29 October 2002:

Follow up:

1. The top four High TB Burden Countries (HBC), China, India, Indonesia and Nigeria, have developed plans to reach additional patients, which were presented and discussed in break-out sessions. The Board will support these activities with finances and high-level missions to increase political commitment.

2. Slow increase in Tuberculosis (TB) case detection requires urgent attention. The DOTS Expansion Working Group (DEWG) will prepare specific proposals for new approaches to increase case detection and notification.

3. Agreement to further strengthen the relationship between Stop TB and GFATM through a Memorandum of Understanding (MOU).

4. Endorsement of 2003 Workplan and budget for the Stop TB Partnership Secretariat.

WHO Regional Committee for Europe, Copenhagen, 16-19 September 2002:

This meeting was the fifty-second session of the WHO Regional Committee for Europe in which representatives of 49 countries of the Region took part. 

One of the main resolutions was as follows:

  • Scaling up the response to tuberculosis, HIV/AIDS and malaria in the European Region of WHO.

If you require detailed information, click on the entire report in pdf format and its resolutions.

Third Taskforce meeting on TB Control for Africa, Harare, 11-13 December 2002:

Over the last decade, Africa has experienced a huge increase in TB cases as a result of the raging epidemic of TB-HIV co-infection. As a consequence, the challenges of TB control have changed and countries are facing new constraints. Many TB control programs are struggling to cope with the workload and require additional and new approaches to effectively control this epidemic. Constraints and proposed solutions for accelerating DOTS Expansion need to be addressed by countries and Stop TB partners. In 1997, the WHO Regional Director constituted a Regional Task Force to advise on strategies to improve TB control and resource mobilisation efforts at the regional level and in Member States. A strategic Plan for Tuberculosis Control in the African Region (2001-2005) was developed in the 2nd Stop TB African Regional Task Force. Commitment on acceleration and implementation are now key follow up steps. 

A list of partners and countries has been invited for the Third Task meeting on TB Control for Africa, subtitled the meeting on 'Building Partnerships to Stop TB in Africa', since this will be the main focus of the forum. Currently, materials are in the final phase of preparation. 

Expected Outcomes from the meeting:

  • Progress made in the implementation of the TB DOTS strategy in the African Region
  • Challenges to accelerating the implementation of the DOTS strategy identified and solutions proposed
  • Recommendations for building partnerships and mobilizing additional resources for TB control in the region
  • Next steps for accelerating DOTS implementation agreed upon
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News from the Communications & Advocacy Team

World AIDS Day, 1 December 2002: 

This year World AIDS Day highlights "Live and let live" — the theme of the World AIDS Campaign 2002-2003. The campaign focuses on eliminating stigma and discrimination, the major obstacles to effective HIV/AIDS prevention and care.

World AIDS Day is commemorated around the globe on 1 December. It celebrates progress made in the battle against the epidemic — and brings into focus remaining challenges. 

While this is an occasion to support local World AIDS Day activities, it is also an opportunity to reinforce the link between HIV/AIDS and TB. Among the most important things we can do to help those living with HIV/AIDS is to have efficient TB control programmes working everywhere. We have already witnessed massive increases in TB in Africa due to AIDS. Those people dually infected with HIV and TB could live much longer if they have access to speedy and efficient diagnosis and treatment. 

  • Please click on the following link for information on the special event UNAIDS are hosting for World AIDS Day
  • Read our Newsletter Issue No.4, which examines how the global community is tackling the burden of TB among HIV-infected people
  • Read Patient Stories of TB/HIV co-infected patients 
  • Find out more information on the TB/HIV Working Group

World TB Day, 24 March 2003:

A reminder that the theme selected for World TB Day 2003 is "People with TB". There are 2 options for the slogan, "DOTS cured me – it will cure you too!" or "DOTS cured me of Tuberculosis – it will cure you too!" 

Feedback has been positive from the Regions on the theme and they find purpose in involving people with TB to be the real advocates for case detection and cure. 

The Secretariat is currently preparing supporting documents and materials to assist countries and partners in their World TB Day activities.

Please click on the following link for translations of the World TB Day theme and slogan in French, Portuguese and Spanish

New features on Website:

  • Please click on Glossary of Acronyms, compiled by the Stop TB team for ease in referencing our documents
  • Please click here to visit the Stop TB Partners Directory. The A-Z Partners list now has web links (where available) to the respective Organisations' websites.
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News from the Stop TB Working Groups (web site)

DOTS Expansion Working Group (DEWG)

First Meeting of the Public-Private Mix Subgroup (PPM) for DOTS Expansion, 25 and 26 November 2002,WHO Headquarters, Geneva:

Background:

The PPM Subgroup was formed this year to increase TB case detection. Currently, DOTS and non-DOTS programmes detect less than 42% of the estimated new cases of TB, while new smear positive cases notified under DOTS represent only one quarter of the estimated total. A substantial proportion of the remaining cases are seeking care in the private medical sector.

In most developing countries, the private sector is growing. In countries such as India, where currently 80% of doctors are in the private sector, involving private doctors in DOTS programmes is very important to reach global TB control targets set by the WHO. The stigma attached to TB is the main reason why patients seek treatment from private practitioners, whether they be real or fake.

Case studies have shown that PPM projects are not only possible but productive as well. An example from Delhi shows that when the local professional association entered into a collaboration with the local National TB Programme (NTP), case detection increased by 58%, with good treatment success of 81%.

Objectives:

1. To draw attention to the urgency and significance of private provider involvement in DOTS expansion and to promote NTP driven PPM for DOTS implementation

2. To review global, regional and country level initiatives on PPM DOTS and their outcomes

3. To recommend steps for member states, WHO Regional offices and HQ to undertake to make PPM DOTS integral to global DOTS expansion

4. To identify issues to address through programme-based operational research

5. To indicate ways for advocacy and resource mobilisation for PPM DOTS

Expected outcomes:

1. An understanding of the current status of, and future needs for, private provider involvement in DOTS expansion in WHO member States and Regional offices

2. An outline of action-oriented steps on development of regional and country level strategies to make PPM DOTS integral to DOTS expansion

3. An agenda for operational research to facilitate PPM DOTS for DOTS expansion

4. Suggestions on advocacy and resource mobilisation for PPM DOTS

Delegates included PPM members from India, Sweden, Nepal, USA, and The Philippines.

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TB/HIV

Workshop on TB/HIV in the former Soviet Union, Vilnius, Lithuania, 31 October - 2 November 2002:

The Albert Schweitzer Institute presented a workshop "TB/HIV in the former Soviet Union - integrating services to address the dual epidemics" in collaboration with the Open Society Institute, in Vilnius, Lithuania, from 31 October - 2 November 2002. 

Participants included representatives at national and district-level from national TB and HIV programmes, organisations of people living with HIV/AIDS (PLWH), development assistance agencies, (USAID), NGOs (KNCV, MSF, Partners in Health), and international organisations (WHO, UNAIDS). 

In small working groups, participants identified the following main TB and HIV programme collaborative activities, with an emphasis on risk groups (mainly Intravenous Drug Users (IDUs) but also prisoners and hospitalised patients): establishment of a national TB/HIV coordinating mechanism; revision of national legal frameworks; surveillance of HIV among TB patients and of TB among PLWH; prevention of nosocomial transmission; establishment of referral systems between services responsible for TB diagnosis and treatment, for HIV/AIDS care and for IDU harm reduction; screening of PLWH for TB with provision of TB preventive treatment for those who are PPD-positive; information, education and communication for risk groups and for health service staff. 

Participants reviewed the draft WHO European Regional Strategic Framework to control TB/HIV, which should be finalised as a consensus document at the annual meeting on European TB control in the Netherlands in June 2003. Please find conference materials, in both English and Russian, online at www.schweitzerinstitute.org.

Visit to the collaborative TB and HIV programme activities in Malawi and Zambia:

Meetings with the major stakeholders and partners in collaborative TB and HIV programme activities in Zambia and Malawi, earlier this month, revealed strong support for the phased implementation of collaborative activities at all levels. Project results and data collection capabilities were reviewed at each of the ProTEST project sites for the development of monitoring and evaluation tools for joint TB/HIV activities and in preparation for a 'lessons learned' workshop early in 2003.

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New TB Drugs

Two Stakeholders Developing Clinical Trial Consortium in South Africa:

Two stakeholders of the TB Alliance are partnering to establish a South African Clinical Trials Consortium with an emphasis on TB-HIV and MDR-TB. The 5-year agreement between the Medical Research Council, the host of TB Alliance offices in Cape Town, and the U.S. Centers for Disease Control and Prevention (CDC), aims to improve infection and resistance control in the context of high levels of TB-HIV co-infection. By upgrading the clinical trial capacity in a key endemic country like South Africa, this initiative will complement and support the TB Alliance‘s efforts to develop new drugs.

“New drugs are urgently needed to address the problem of today’s long treatment period of 6 months, growing numbers of new TB cases arising from latent infection exacerbated by HIV co-infection, as well as the challenges posed by MDR TB,” said Dr Bernard Fourie, Director of the MRC’s Lead Programme for TB Research and coordinator of the TB Alliance R&D Coalition, who will be heading the SATB Trials.

For full press release: http://www.mrc.ac.za/pressreleases/2002/19pres2002.htm

For more on CDC Clinical Trial Consortium: http://www.cdc.gov/nchstp/tb/tbtc/default.htm

For more on MRC: http://www.mrc.ac.za/home.html

Scientific Advisory Committee: Accelerate Genomic Research & Screen for New Compounds:

The TB Alliance Scientific Advisory Committee (SAC) reviewed progress and outlined future research directions for the ongoing R&D strategy of the TB Alliance at its regular meeting in Montreal, coinciding with the IUATLD annual convention and the TB Alliance Stakeholders Meeting.

After completing an initial review of promising TB drug candidates from among lead compounds identified over the last year, the SAC recommended that the TB Alliance continue its current development plans and expand the range of potential compounds by leveraging recent TB genomic research. New genomic information on the TB bacterium will identify new targets and provide ways to screen large compound libraries for new leads. The TB Alliance intends to explore the potential of recently identified, latency-associated biochemical pathways for the identification of new valuable compounds that will improve treatment of latent infection and shorten the duration of treatment for the active disease.

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News from the Global Drug Facility (GDF) (web site)

GDF Applications/Review Update:

The current situation with regards to applications and review is as follows:

Activity

To date
Rounds of applications and review 5
Number of applications received 60
Number of countries approved for support 37
Drug orders placed 24
Number of patient treatments approved (inc. buffer stocks) >1,600,000
Number of countries which have received drug deliveries 14
  • The secretariat is organising country visits to all 4th /5th round countries as well as monitoring visits to all 1st and 2nd round countries.
  • The secretariat will begin accepting applications for the sixth round of review in December 2002 (closing date of early February 2003). Copies of the GDF application forms are available on the GDF website at www.globaldrugfacility.org in English, French, Russian and Spanish. NGO application forms are also available.

GDF Procurement/Supply Update:

  • A list of the currencies accepted by the GDF Procurement Agent, as convertible currencies, that can be accepted as payment from clients against the GDF Direct Procurement mechanism has recently been posted on the GDF website: /GDF/drugsupply/Direct_procurement_process.html
  • A second invitation of Expressions of Interest (EOI) to manufacturers interested in being pre-qualified as suppliers of specific TB products through the GDF, will be issued in November/December 2002.
  • A Request for Proposals (RFP) will be issued by the STOP TB Partnership to procurement agents who have expressed interest in becoming the procurement agent for the GDF and who meet the minimum requirements, in December 2002.
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Calendar of Events (web site)

For more information on upcoming events, please click on the above link:

December 2002:

  • World AIDS Day,
    Switzerland, Geneva, December 1
  • Launch of the State of World Population 2002,
    Switzerland, Geneva, UNFPA, December 4
  • Human Rights Day,
    Switzerland, Geneva, OHCHR, December 10
  • South East Asia TB Technical Advisory Group (TAG),
    Thailand, Bangkok, December 10-12
  • 4th National Conference on Laboratory Aspects of Tuberculosis
    USA, San Francisco, CA, December 10-13
  • 3rd Meeting of the Stop TB Taskforce, African Region,
    Zimbabwe, Harare, December 11-13
  • IUATLD Conference of the Latin American Region,
    Uruguay, Punta del Este, December 12-14
  • Daan Mulder Memorial Symposium - Current Status of Knowledge on the Epidemiology, Natural History and Control of Tuberculosis,
    UK, London, December 13 [more information: pdf file (16kb)]
  • 2nd National Multisectoral AIDS Conference,
    Tanzania, Arusha, December 16-20
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 New TB Documents (web site)

The following documents are now available by clicking on the above link.

  • Community contribution to TB care:  a Latin American perspective now available in Spanish in pdf format - WHO/CDS/STB/2002.304
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    'Stop TB' - a global movement to accelerate social and political action to stop the spread of tuberculosis around the world. For further information please contact the Stop TB Secretariat at: stoptbinfo@who.int